Licensing Standards for DayCare Centers
Health Supervision and Infectious Disease Prevention
(1) Child. The licensee shall encourage the parent to arrange a physical examination
for the child who has not had regular health care or a physical examination
within one year before enrollment.
(2) The licensee shall encourage the parent to obtain health care for the
child when necessary. The licensee shall not be responsible for providing or
paying for the child's health care.
(3) Before or on the child's first day of attendance, the licensee shall have
on file a certificate of immunization status form prescribed by the department
of health proving the child's full immunization for:
(4) The licensee may accept the child without all required immunizations on a
conditional basis if immunizations are:
- (a) Diphtheria;
- (b) Tetanus;
- (c) Pertussis (whooping cough);
- (d) Poliomyelitis;
- (e) Measles (rubeola);
- (f) Rubella (German measles);
- (g) Mumps; and
- (h) Other diseases prescribed by the department of health.
(5) The licensee may exempt the immunization requirement for the child if the
parent or guardian:
- (a) Initiated before or on enrollment; and
- (b) Completed as rapidly as medically possible. -
(6) Program. Staff shall daily observe and screen the child for signs of illness.
The licensee shall care for or discharge home the ill child based on the center's
policies concerning the ill child.
- (a) Signs a statement expressing a religious, philosophical, or personal
- (b) Furnishes a physician's statement of a valid medical reason for the
(7) Staff shall wash, or assist the child to wash hands:
- (a) When the child has a severe illness or is injured, tired, or upset,
staff shall separate the child from other children and attend the child continuously
- (i) The child is able to rejoin the group;
- (ii) Staff return the child to the parent; or
- (iii) Staff secure appropriate health care for the child.
- (b) The licensee shall provide a quiet, separate care room or area allowing
the child requiring separate care an opportunity to rest.
- (c) Staff shall sanitize equipment used by the child if staff suspects
the child has a communicable disease.
- (d) The licensee may use the separate care room or area for other purposes
when not needed for separation of the child.
(8) Staff shall clean and disinfect toys, equipment, furnishings, and facilities
according to the center's cleaning and disinfecting policies, as needed.
- (a) After the child's toileting or diapering;
- (b) Before the child eats; and
- (c) Before the child participates in food activities.
(9) The licensee shall have appropriate extra clothing available for the child
who wets or soils clothes.
(10) Staff shall ensure the child does not share personal hygiene or grooming
(11) Staff. Each center employee, volunteer, and other person having regular
contact with the child in care shall have a tuberculin (TB) skin test, by the
Mantoux method, upon employment or licensure, unless against medical advice.
(12) The licensee shall not permit the person with a reportable communicable disease
to be on duty in the center or have contact with the child in care unless approved
in writing by a health care provider.
- (a) The person whose TB skin test is positive (ten millimeters or more
induration) shall have a chest x-ray within thirty days following the skin
- (b) The licensee shall not require the person to obtain routine periodic
TB retesting or x-ray (biennial or otherwise) after entry testing unless directed
to obtain retesting by the person's health care provider or the local health
(13) Staff shall wash hands:
[Statutory Authority: RCW 74.15.020 and 74.15.030. 93-18-001 (Order 3623), §388150-220,
filed 8/18/93, effective 9/18/93. Statutory Authority: RCW 74.15.030. 90-23-078
(Order 3103), § 388-150-220, filed 11/20/90, effective 12/21/90.]
- (a) After toileting and diapering the child;
- (b) After personal toileting;
- (c) After attending to an ill child; and
- (d) Before serving or preparing food.